RESUMO
BACKGROUND: The major concern regarding the use of low-dose oral minoxidil (LDOM) for the treatment of hair loss is the potential risk of systemic adverse effects. OBJECTIVE: To describe the safety of LDOM for the treatment of hair loss in a large cohort of patients. METHODS: Retrospective multicenter study of patients treated with LDOM for at least 3 months for any type of alopecia. RESULTS: A total of 1404 patients (943 women [67.2%] and 461 men [32.8%]) with a mean age of 43 years (range 8-86) were included. The dose of LDOM was titrated in 1065 patients, allowing the analysis of 2469 different cases. The most frequent adverse effect was hypertrichosis (15.1%), which led to treatment withdrawal in 14 patients (0.5%). Systemic adverse effects included lightheadedness (1.7%), fluid retention (1.3%), tachycardia (0.9%), headache (0.4%), periorbital edema (0.3%), and insomnia (0.2%), leading to drug discontinuation in 29 patients (1.2%). No life-threatening adverse effects were observed. LIMITATIONS: Retrospective design and lack of a control group. CONCLUSION: LDOM has a good safety profile as a treatment for hair loss. Systemic adverse effects were infrequent and only 1.7% of patients discontinued treatment owing to adverse effects.
Assuntos
Alopecia/tratamento farmacológico , Minoxidil/efeitos adversos , Administração Oral , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Tontura/induzido quimicamente , Tontura/epidemiologia , Edema/induzido quimicamente , Edema/epidemiologia , Feminino , Cefaleia/induzido quimicamente , Cefaleia/epidemiologia , Humanos , Hipertricose/induzido quimicamente , Hipertricose/epidemiologia , Masculino , Pessoa de Meia-Idade , Minoxidil/administração & dosagem , Estudos Retrospectivos , Distúrbios do Início e da Manutenção do Sono/induzido quimicamente , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Taquicardia/induzido quimicamente , Taquicardia/epidemiologia , Adulto JovemRESUMO
low dose oral minoxidil (OM) is an increasingly used treatment for androgenetic alopecia and other types of hair loss. to analyze available data of patients treated with OM, focusing on safety and adverse effects. a search in PubMed and EMBASE was performed for studies reporting the treatment of alopecia with OM. Individual patient data available for pooled-analysis were sex, dose of OM, presence of hypertrichosis and lower limb edema. 14 studies including 442 patients were analyzed. OM was used at doses between 0.25 and 5 mg, for eight different types of alopecia. Hypertrichosis was observed in 24% of patients. All doses had an increased odds ratio of hypertrichosis, compared to 0.25 to 0.5 mg (P < .001). Pedal edema was observed in 2% and was also associated with higher doses of OM (P = .009). Postural hypotension and heart rate alterations occurred only in 1.1% and 1.3% of the patients, respectively. Efficacy of OM could not be analyzed due to heterogeneous studies. However, four studies using OM for androgenetic alopecia reported a clinical response in 70% to 100% of the patients. Low dose OM is a safe and well-tolerated treatment for hair loss, presenting a lower adverse effect rate than standard doses.
Assuntos
Hipertricose , Minoxidil , Alopecia/diagnóstico , Alopecia/tratamento farmacológico , Humanos , Minoxidil/efeitos adversos , Resultado do TratamentoRESUMO
The objective of our study was to describe the effectiveness and safety of oral dutasteride (OD) for male androgenetic alopecia in real clinical practice. A retrospective, monocentric, and descriptive study was designed. Male patients with androgenetic alopecia that had received OD for at least 12 months were included. Three or less capsules of 0.5 mg per week were considered low doses. Therapeutic response was assessed by comparison of pre- and post-treatment (at month 12) clinical images by three independent dermatologists with expertise in hair disorders, using a four-point scale (worsening, stabilization, mild improvement or marked improvement). In all, 307 patients with a mean age of 35.3 years (range 18-79) were included. Eight patients (2.6%) required the discontinuation of the drug due to decreased libido (n = 4), gynecomastia (n = 2), mood disorder (n = 1) and erectile dysfunction (n = 1). All these AE resolved after stopping the medication. No AE were detected in patients receiving low doses of OD. The effectiveness was evaluated in the subgroup of 42 patients (13.7%) who received OD in monotherapy: 38 patients improved (90%), 10 of them (23.8%) presenting a marked improvement, 4 patients (9.5%) were stable and none patient worsened. In conclusion, OD is an effective treatment for male androgenetic alopecia in real clinical practice, presenting a good safety profile, especially at lower doses.
Assuntos
Inibidores de 5-alfa Redutase/administração & dosagem , Alopecia/tratamento farmacológico , Dutasterida/administração & dosagem , Inibidores de 5-alfa Redutase/efeitos adversos , Administração Oral , Adolescente , Adulto , Idoso , Dutasterida/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemAssuntos
Anti-Hipertensivos/efeitos adversos , Hipertricose/induzido quimicamente , Minoxidil/efeitos adversos , Adolescente , Adulto , Idoso , Alopecia/tratamento farmacológico , Anti-Hipertensivos/administração & dosagem , Feminino , Remoção de Cabelo , Humanos , Hipertricose/terapia , Masculino , Pessoa de Meia-Idade , Minoxidil/administração & dosagem , Estudos Prospectivos , Índice de Gravidade de Doença , Adulto JovemAssuntos
Alopecia/tratamento farmacológico , Cabelo/efeitos dos fármacos , Líquen Plano/tratamento farmacológico , Minoxidil/administração & dosagem , Administração Oral , Adulto , Idoso , Alopecia/etiologia , Alopecia/patologia , Feminino , Cabelo/patologia , Humanos , Hipertricose/induzido quimicamente , Hipertricose/diagnóstico , Hipertricose/epidemiologia , Hipotensão Ortostática/induzido quimicamente , Hipotensão Ortostática/diagnóstico , Hipotensão Ortostática/epidemiologia , Líquen Plano/complicações , Líquen Plano/patologia , Masculino , Pessoa de Meia-Idade , Minoxidil/efeitos adversos , Estudos Retrospectivos , Taquicardia/induzido quimicamente , Taquicardia/diagnóstico , Taquicardia/epidemiologia , Resultado do Tratamento , Aumento de Peso/efeitos dos fármacosAssuntos
Alopecia/tratamento farmacológico , Minoxidil/administração & dosagem , Vasodilatadores/administração & dosagem , Administração Oral , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Minoxidil/efeitos adversos , Estudos Retrospectivos , Índice de Gravidade de Doença , Resultado do Tratamento , Vasodilatadores/efeitos adversos , Adulto JovemAssuntos
Alopecia/cirurgia , Cicatriz/cirurgia , Cabelo/transplante , Adulto , Idoso , Alopecia/diagnóstico por imagem , Alopecia/patologia , Cicatriz/diagnóstico por imagem , Cicatriz/patologia , Dermoscopia , Feminino , Seguimentos , Cabelo/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Retrospectivos , Pele/diagnóstico por imagem , Pele/patologia , Fatores de Tempo , Resultado do TratamentoAssuntos
Alopecia/tratamento farmacológico , Azatioprina/administração & dosagem , Cabelo/crescimento & desenvolvimento , Qualidade de Vida , Administração Oral , Adulto , Alopecia/diagnóstico , Alopecia/psicologia , Estudos de Coortes , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Seguimentos , Cabelo/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Adulto JovemAssuntos
Corticosteroides/administração & dosagem , Alopecia/tratamento farmacológico , Dexametasona/administração & dosagem , Cabelo/crescimento & desenvolvimento , Administração Oral , Corticosteroides/efeitos adversos , Adulto , Alopecia/diagnóstico , Estudos de Coortes , Dexametasona/efeitos adversos , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Feminino , Seguimentos , Cabelo/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pulsoterapia , Resultado do Tratamento , Adulto JovemRESUMO
Folliculitis decalvans (FD) is a primary neutrophilic scarring alopecia characterized by perifollicular papules, crusts, and pustules frequently located on the vertex. FD may affect young men and women. Since it may lead to hair loss, it can have a negative impact on patients' quality of life. Nevertheless, studies have focused on clinical, prognostic, and therapeutic aspects without considering the psychological impact of FD. In our study, we found that FD patients experienced a considerable impact on their quality of life. Interestingly, almost half of the patients considered that their alopecia was related to a poor medical care in their past. To our knowledge, this is the first description of the impact of FD on patients' quality of life, and it highlights the importance of psychological support for these patients.